Development and validation of a gut motility based model for predicting bowel preparation quality

Area of Science:

• Gastroenterology
• Medical Diagnostics

Background:

• Inadequate bowel preparation compromises colonoscopy quality, leading to missed lesions and repeat procedures.
• Gut motility is crucial for bowel cleansing but often overlooked in risk assessment for poor preparation.

Purpose of the Study:

• To develop and validate a predictive model and scoring system for inadequate bowel preparation.
• To integrate gut motility parameters into a user-friendly tool for risk stratification.

Main Methods:

• A predictive model was developed and validated using data from 1,165 patients across two hospitals.
• Multivariate analysis identified key predictors: altered bowel movement frequency, Bristol Stool Scale consistency, low polyethylene glycol (PEG) volume, and delayed last bowel movement.
• A simplified scoring system was created and evaluated for discriminative ability.

Main Results:

• The overall rate of inadequate bowel preparation was 9.8%.
• The scoring system demonstrated good discriminative ability with AUCs of 0.778 (training) and 0.774 (validation).
• A cutoff score of 3.0 achieved 75.0% sensitivity and 96.3% negative predictive value in external validation.

Conclusions:

• A motility-informed scoring system effectively identifies patients at risk of inadequate bowel preparation.
• This practical tool enables personalized preparation regimens, potentially enhancing colonoscopy effectiveness and efficiency.
• Integrating gut motility assessment can improve patient outcomes and healthcare resource utilization.